Dengue keeps its date with India's Capital

As rains lash the capital every other day, it's not all reason to rejoice. Accompanying the monsoon each year is dengue, the mosquito-borne disease that killed 65 people last year.

And with the capital receiving 184.6 mm rain on Thursday, things don't seem too bright. There have been six confirmed cases of dengue in New Delhi so far.

Doctors, civic authorities and common people are wondering if there will be a repeat of 2006 when 3,364 dengue cases were reported, the worst in five years, according to the National Vector Borne Disease Control Programme (NVBDCP).

"We are doing our bit but people should be held legally responsible if they allow water to accumulate in their homes and neighbourhood. The Aedes mosquito is known to breed in any container filled with water or wherever rainwater gets accumulated," said NK Yadav, the health officer in the Municipal Corporation of Delhi.

So what is it that makes dengue an annual event in Delhi? The rainy season is considered to be the ideal time for the fresh water mosquito Aedes Aegypti, which is responsible for diseases like dengue and chikungunya, to breed.

Every year the downpour marks the beginning of the dengue season, which lasts nearly three-four months. Poor surveillance and management had led to the outbreak last year. But health officials as well as doctors say the onus lies as much with residents.

SP Byotra, senior consultant in the department of medicine in Sir Gangaram Hospital, said people should keep their surroundings clean.

"During monsoon, water collects very easily inside homes, parks and nearby areas. Even though the government does its bit like spreading awareness and carrying out fumigation especially in areas where there is apprehension of water getting accumulated, people should be alert and take precautionary measures like sleeping under mosquito nets and isolating the patient," Byotra told IANS.

The situation at the All India Institute of Medical Sciences (AIIMS) becomes critical during dengue outbreaks. With patients pouring in from all parts of northern India, even for screening tests, AIIMS authorities have a tough time handling the crisis.

Last year the pavements outside the AIIMS emergency came to be called "Dengue Lanes", as families accompanying patients with fever and dengue symptoms pitched tents there for months together. Patients running high fever and showing symptoms of dengue lay outside on stretchers while their relatives endlessly queued up to collect test reports.

In the paediatric emergency department at AIIMS, children were forced to share stretchers. With more than 1,200 samples being screened every day in the laboratory, the overwhelmed AIIMS staff had to stop admission in various departments in order to manage dengue patients.

"We became a victim of our own efficiency. We can't turn away patients but the burden was too much to handle," recalled DK Sharma, the AIIMS medical superintendent.

But even as people affected with dengue battled the disease in hospital, there were areas in Delhi where people continued to live in unclean surroundings, giving the Aedes mosquito its new victims.

Though dengue cases are reported round the year in Delhi, the numbers shoot up during monsoon and the months following it.

Another very important reason for the recurrence of dengue in Delhi every year is the influx of migrant population from areas affected by dengue, mostly from states in southern India such as Kerala, Andhra Pradesh and Tamil Nadu. These people prove to be effective carriers of the virus.

Once the virus enters a particular area in Delhi it's difficult to stop the man-mosquito-man cycle. Till the time people realise the importance of sanitation and take preventive measures to stop the breeding of the Aedes mosquito in their homes and offices, the efforts of civic authorities alone will not be enough to stop the spread of dengue in Delhi.